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Monthly State Update:
MAJOR DEVELOPMENTS IN 2009

(as of 11/1/2009)

This
update provides information on legislation, as well as relevant
executive branch actions and judicial decisions in states across
the country. For each of the topics listed below, the number of
states in which legislation has been introduced is given, as are
the names of the states in which subsequent action has been taken.
Detailed summaries are provided for legislation that has been passed
by at least one house of a legislature and for major court decisions;
actions for the current month are in bold. For an archive of previous
monthly updates, click here.

Abortion Bans to Replace Roe

MONTANA: In March, the House defeated a measure that would have put an initiative on the 2010 ballot to ban all induced abortions in the state. The measure was approved by the Senate in February.

MONTANA: In March, the House defeated a measure that would have put an initiative on the 2010 ballot to define a fetus as a human being from the moment of fertilization or conception. The measure was approved by the Senate in February.

NORTH DAKOTA: In April, the Senate defeated a House measure that would have entitled all persons, defined by the measure as any organism possessing a human genome, to equal rights and privileges under state law and the state constitution. The measure, which had passed the House in February, is now dead.

TENNESSEE: In June, the Senate accepted a non-substantive change to an amendment that would establish that the state constitution does not protect the right to abortion. The change ensures that the amendment is introduced in the 2010 legislative session. In order to amend the state Constitution, the amendment must be adopted by the majority of both chambers during a legislative session and then by a two-thirds majority during the following session. Then the amendment may be put before the voters in the next election. The amendment passed the House in May.

(ENACTED) LOUISIANA: In July, Gov. Bobby Jindal (R) signed into law a measure that requires monies earned from the sale of “Choose Life” license plates be given to and distributed by the Right to Life Education Committee. The law also eliminates the state’s Choose Life Fund, to which receipts from the license plates were allocated. The law, which passed the legislature in June, is in effect.

MISSOURI: In March, the United States Court of Appeals for the Eighth Circuit upheld a lower court ruling allowing the state to manufacture and sell “Choose Life” license plates; funds generated from the sale of the plates would go to crisis pregnancy centers. The state has not decided whether to appeal to the U.S. Supreme Court.

(ENACTED) VIRGINIA: In March, Gov. Tim Kaine (D) signed a bill to authorize the sale of “Choose Life” license plates. Money generated from the sale of the plates would be allocated to crisis pregnancy centers across the state. The measure, which passed the legislature in February, goes into effect July 1, 2009.

Crisis
Pregnancy Centers/Alternatives to Abortion

Introduced in 13 states

Bill Status:

Enacted in KS, LA, MO, ND, OK, PA, TX and WI

(ENACTED) KANSAS: In April, Gov. Kathleen Sebelius (D) signed a bill that allocates $355,000 to fund alternatives-to-abortion services. The bill passed the legislature in March and goes into effect in July.

(ENACTED) LOUISIANA: In June, Gov. Bobby Jindal (R) signed into law a measure that allocates $1.5 million to fund alternatives-to-abortion services. The bill passed the legislature in June and goes into effect in July.

(ENACTED) MISSOURI: In June, Gov. Jay Nixon (D) signed into law the state’s budget bill that allocates $2 million to provide alternatives-to-abortion services for any pregnant woman at or below 200% of the federal poverty level. The program will offer a range of services to a woman during her pregnancy and for one year following birth. Program funding cannot be used for services related to family planning or abortion, and cannot be provided to organizations that offer abortions or abortion referrals. The measure, which passed the House in March and the Senate in April, goes into effect in July.

(ENACTED) NORTH DAKOTA: In May, Gov. John Hoeven (R) signed a measure appropriates funds to promote the state’s alternatives-to-abortion program. The measure, which passed the Senate in February and the House in April, goes into effect in August.

(ENACTED) OKLAHOMA: In May, Gov. Brad Henry (D) signed a bill that appropriates funds for the Alternatives to Abortion Revolving Fund. The fund cannot be used by organizations that support or perform abortions. The measure, which was one of three that passed the House in February and the Senate in April, goes into effect in July.

(ENACTED) PENNSYLVANIA: In October, Gov. Ed Rendell (D) signed two measures into law that re-enact longstanding guidelines for the state to use when allocating the alternatives-to-abortion fund. The guidelines prohibit nonprofit organizations receiving the funds from offering abortion services, counseling or referral. Organizations receiving these monies must maintain a strict separation from organizations providing abortion services. The laws, which passed the House and the Senate in October, are in effect.

(ENACTED) PENNSYLVANIA: In August, Gov. Ed Rendell (D) signed into law a measure that will allocate $5.7 million to fund alternatives-to-abortion programs. The law, which passed the Senate in May and the House in August, is in effect.

(ENACTED) TEXAS: In June, Gov. Rick Perry (R) signed into law the state’s budget bill that includes a provision that will fund alternatives-to-abortion services. The bill, which passed the legislature in April, continues longstanding restrictions on state family planning funds. The law goes into effect in September.

(ENACTED) WISCONSIN: In June, Gov. Jim Doyle (D) signed the state’s budget that allocates $154,000 for “pregnancy counseling” offered by organizations that do not provide abortion services, including counseling or referral. The budget, which also includes a provision altering the state’s Medicaid family planning expansion to include men, mandates contraceptive coverage for health insurance policies and requires pharmacies to fill valid contraceptive prescriptions and dispense Plan B, was adopted by the legislature in June, and goes into effect in July.

Fetal
Pain

Introduced in 7 states (These bills overlap with bills in the Mandatory Counseling, Waiting Period and Ultrasound Requirements categories.)

Bill Status:

Passed at least one chamber in IN and MO

Enacted in UT

INDIANA: In April, the House passed a measure that would require abortion providers to inform women seeking an abortion that there is “differing evidence that a fetus feels pain.” The measure, which passed the Senate in February, also contains a provision requiring abortion providers to have hospital admitting privileges. No further action is expected since the legislature has adjourned its regular session.

INDIANA: In February, the Senate approved a measure that would require an abortion provider to inform a woman seeking an abortion that there is differing evidence as to whether a fetus can feel pain. The measure, which also contains counseling provisions, is not expected to receive further action since the legislature has adjourned its regular session.

MISSOURI: In May, the Senate passed a measure that would require an abortion provider to give a woman having an abortion after 21 weeks of pregnancy medically accurate materials developed by the statethat include information on fetal pain and anesthesia. The bill, which also contains provisions regarding abortion counseling, hospital requirements and ultrasound, was adopted by the House in March. The measure died in a conference committee when the legislature adjourned.

(ENACTED) UTAH: In March, Gov. Jon Huntsman Jr. (R) signed a bill requiring that a woman who is seeking an abortion at 20 weeks’ gestation or more be offered anesthesia for the fetus and verbal counseling and state-developed written materials on this option. The materials will be required to be “truthful and nonmisleading” and include information on the potential risk to the woman’s health from providing pain medication to the fetus. The provider is not required to offer the materials or the option of providing fetal anesthesia if the woman’s life is endangered, if there is a substantial risk to her health or in cases of medical emergency. The measure, which passed the House in February and the Senate in March, goes into effect in May.

Introduced in 11states (These bills overlap with bills in the Fetal Pain and Ultrasound Requirements categories.)

Bill Status:

Passed at least one chamber in IN, KS MO and TX

Enacted in KS and ND

Vetoed in KS

INDIANA: In February, the Senate passed a bill that would require an abortion provider to inform a woman seeking an abortion that an embryo begins to “grow as human physical life” from the moment of fertilization. The provider would also be required to give the woman written information on the physical risks of carrying a pregnancy to term and the risks of abortion, as well as the availability of adoption as an alternative. The measure, which also contains a provision related to fetal pain, is not expected to receive further action since the legislature has adjourned its regular session.

KANSAS: In May, the Senate failed in its attempt to override then-Gov. Kathleen Sebelius’ (D) veto of a measure that would have amended the state’s abortion counseling requirements to require that the materials given to a woman seeking an abortion include a statement that the procedure would “terminate the life of a whole, separate, unique human being.” The measure, which passed the legislature in April, would have also banned “partial-birth” abortion and amended the state’s requirements for abortion reporting, postviability abortion and abortion counseling.

KANSAS: In March, the House approved a measure that would require an abortion provider to inform a woman seeking an abortion that the fetus is a “separate, whole, unique person.” The measure, which also contains provisions regarding postviability abortion counseling, abortion reporting, and partial-birth abortion, is not expected to receive further action since another bill with these provisions was vetoed by then-Gov. Kathleen Sebeleius (D) in April.

(ENACTED) KANSAS: In March, Gov. Kathleen Sebelius (D) signed a bill expanding the requirements for the written materials abortion providers give to women seeking an abortion. The measure requires the materials to include contact information for perinatal hospices and a list of organizations that provide free ultrasound examinations. It also requires the provider to inform the woman that these materials are available online. The measure, which also contains provisions regarding coercion and ultrasound, passed the legislature in March and goes into effect July 1, 2009.

MISSOURI: In May, the Senate adopted an omnibus abortion bill that amends the state’s abortion counseling requirements. The measure would require a provider to give a woman seeking an abortion written materials developed by the state. These materials would contain information on fetal development, resources for continuing a pregnancy to term and a statement that “the life of each human being begins at conception,” and that “unborn children have protectable interests in life, health and well-being.” The provider would also be required to inform the woman of the probable gestational age of the fetus. The bill, which passed the House in March, also contains provisions regarding ultrasound, hospital requirements and fetal pain. The measure died in a conference committee when the legislature adjourned.

(ENACTED) NORTH DAKOTA: In April, Gov. John Hoeven (R) signed into law a measure that requires abortion providers to inform women seeking an abortion that the procedure would end the life of a “whole, separate and unique human being.” The measure, which passed the House in February and the Senate in April, goes into effect August 1, 2009.

SOUTH DAKOTA: In August, the U.S. District Court of South Dakota issued a long-awaited decision on the state’s 2005 abortion counseling law. The court upheld as constitutional a provision that requires that a woman seeking an abortion be told that the procedure “will terminate the life of a whole, separate, unique, living human being,” U.S. District Judge Karen Schreier said that such information is relevant to the woman in a “biological sense and not an ideological sense.” The court struck down three other counseling requirements—that a woman be told she has an existing legal relationship with the fetus, that an abortion will end that relationship and that abortion increases the risk of suicide—describing them as “untruthful and misleading.”

TEXAS: In May, the Senate adopted an omnibus abortion bill containing provisions that would amend the state’s abortion counseling requirements. The bill would require the physician performing an abortion to tell the woman the gestational age of the fetus and give her medically accurate information on the risks of the procedure, including infection, hemorrhage, infertility and breast cancer, and of carrying the pregnancy to term. Under current law, the physician may delegate these counseling requirements. The measure would also require the provider to give the woman state-developed abortion counseling materials; current law only requires that the woman be offered the materials. The measure would require counseling to be provided either through a telephone conversation or in person. The bill, which also includes provisions related to ultrasound and medical emergency, died at the end of the regular session.

Requirements for State-Directed Counseling
Followed by a Waiting Period

Introduced in 11 states (These bills overlap with bills in the Fetal Pain and Ultrasound Requirements categories.)

Bill Status:

Passed at least one chamber in KY and SC

Enacted in AZ

ARIZONA: In September, a state judge allowed several provisions of a new state statute to go into effect, including a 24-hour waiting period for women seeking an abortion and standards for abortion counseling, but blocked enforcement of a requirement for in-person abortion counseling. The court blocked several other sections of the statute, including provisions related to parental consent, physician-only requirements and refusal clauses; it permitted implementation of provisions relating to coercion, medical emergency and minors’ abortions. The law was enacted in July.

KENTUCKY: In March, the House and Senate approved separate but identical measures that would mandate an in-person counseling session 24 hours before an abortion procedure, in effect necessitating that a woman make two clinic trips to obtain an abortion. (The state currently permits the counseling to take place by mail or phone.) The measures, which also contain an ultrasound provision, are not expected to advance further since the legislature has adjourned its regular session.

SOUTH CAROLINA: In February, the House passed a bill that would require a woman to wait 24 hours between receiving state-mandated counseling materials and obtaining an abortion. Under current law, the waiting period is one hour. The measure would also expand the requirements for an ultrasound provided in advance of an abortion. No further action is expected since the legislature had adjourned its regular session.

Medical Emergency Exception in Abortion Law

Introduced in 11 states

Bill Status:

Passed at least one chamber in AK

Enacted in AZ

ALASKA: In April, a Senate committee defeated a measure that would have limited the medical emergency exception to the state’s requirement that a minor seeking an abortion obtain parental consent. Under the measure, the exception would have no longer applied to an abortion necessary to preserve a minor’s mental health. The measure, which also contains a parental consent provision, passed the House in April. No further action is expected since the legislature has adjourned its regular session.

ARIZONA: In September, a state judge allowed several provisions of a new state statute to go into effect, including an exemption from the abortion counseling and waiting period requirement in cases of medical emergency. The court blocked several other sections of the statute, including provisions related to in-person abortion counseling, parental consent, physician-only requirements and refusal clauses; it permitted implementation of provisions relating to standards for abortion counseling, a waiting period, coercion, medical emergency and minors’ abortions. The law was enacted in July.

Medication
Abortion

Introduced in 0 states

OHIO: In July, the Supreme Court of Ohio upheld the state’s 2004 law, which limits the provision of mifepristone by requiring physicians to adhere to the precise terms of the FDA approval, which bars them, for example, from altering the dosage or administration even if done in light of new scientific evidence. In addition, the law precludes an exception to protect the woman's life or health. The law is in effect.

Minors
Reporting Requirements

Introduced in 3 states

Bill Status:

Enacted in OK

(ENACTED) OKLAHOMA: In May, Gov. Brad Henry (D) signed into law a measure that will require abortion providers to report extremely detailed information regarding minors’ abortions, including whether physicians received the mandatory parental consent, whether minors sought judicial bypass and whether a bypass was granted. Similar language was passed by the legislature in 2007 in an omnibus abortion bill. The bill, which passed the House in February and the Senate in April, will also ban abortions performed based on the sex of the fetus and expand abortion reporting requirements. The bill goes into effect in November.

ALASKA: In April, a Senate committee defeated a measure that would have amended the state’s parental consent statute—which is currently enjoined—to also require parental notice before a minor procures an abortion. The measure, which passed the House in April, would also have added an abuse exemption to the parental notification and consent provision and would have prohibited anyone from coercing a minor into having an abortion. No further action is expected as the legislature has adjourned its regular session.

ARIZONA: In September, a state court judge blocked enforcement of a provision of a new state statute that would have required that parental consent forms be notarized. The court ruled that the law can go into effect as soon as the state establishes a notarization process that protects the minor’s privacy. The court allowed implementation of provisions that establish standards for the court to use in deciding whether to grant a judicial bypass and prevent an emancipated minor from using public funds, such as welfare benefits, to pay for an abortion. The court blocked several other sections of the statute, including provisions related to in-person abortion counseling, physician-only requirements and refusal clauses; it permitted implementation of provisions relating to a waiting period, standards for abortion counseling, coercion and medical emergency. The law was enacted in July.

ILLINOIS: In July, the U.S. Court of Appeals for the Seventh Circuit reversed a Federal District Court’s 2008 decision, clearing the way for the implementation of a notification law for the first time since it was enacted in 1995. The law requires providers to notify a parent or an adult family member at least 48 hours in advance of a minor’s abortion. Notice can be waived by a judge and is not required in cases of medical emergency or sexual abuse. The law is expected to go into effect in November. (Update: A new court case was filed in October in a state court. In early November, the judge blocked in the law pending resolution of the lawsuit.)

MONTANA: In March, a House committee defeated a measure that would have allowed a judge to grant a judicial bypass if an abortion is in the best interest of the minor. This bill is an attempt to make the state’s currently enjoined parental notification law constitutional. The bill passed the Senate in February.

'Partial-Birth' Abortion

(ENACTED) ARIZONA: In July, Gov. Jan Brewer (R) signed a bill that revises the state’s ban on “partial-birth” abortion. This bill would modify the currently enjoined law to mirror the federal ban. The measure, which passed the House in March and the Senate in June, goes into effect at the end of September.

(ENACTED)ARKANSAS: In February, Gov. Mike Beebe (D) signed a measure that bans the performance of a “partial-birth” abortion. The new law allows the procedure if it is performed in order to save the woman’s life. The state’s existing “partial-birth” abortion ban has never been in effect because of judicial action. The new law, which passed the legislature in February and went into effect when signed, mirrors the language in the federal law that was upheld in April 2007.

KANSAS: In May, the Senate failed in its attempt to override then-Gov. Kathleen Sebelius’ (D) veto of a measure that would have amended the state’s ban on “partial-birth” abortion by revising the definition of “partial-birth” abortion to mirror the definition in federal law. The measure, which passed the legislature in April, would have also amended the state’s laws on postviability abortion, abortion counseling and abortion reporting.

KANSAS: In March, the House passed a measure that would amend the state’s ban on “partial-birth” abortion by revising the definition of “partial-birth” abortion to mirror the definition in federal law. The measure would also amend the state’s laws on postviability abortion, abortion counseling and abortion reporting. No further action is expected since a similar bill was vetoed by then-Gov. Kathleen Sebelius (D) in April.

VIRGINIA: In June, the U.S. Court of Appeals for the Fourth Circuit upheld the state’s “partial-birth” abortion ban. The law had never been in effect and was the subject of litigation since it was enacted in 2003. The law prohibits intact D&E abortions except in cases to protect the woman’s life. Relying on the 2007 U.S. Supreme Court decision upholding the federal “partial-birth” abortion ban, the circuit court ruled that the law is not vague and that a health exception is not necessary.

Physician Liability

Physician-Only
Requirements

ARIZONA: In September, a state court judge blocked enforcement of several provisions of a new state statute, including a restriction that would have allowed only physicians to perform surgical abortions. Also blocked is a provision that would have required abortion counseling to be performed by a physician; making it virtually impossible for nurses to provide medication abortions. The court blocked several other sections of the statute, including provisions related to in-person abortion counseling, parental consent and refusal clauses; it permitted implementation of provisions relating to a waiting period, standards for abortion counseling, coercion, medical emergency and minors’ abortions. The law was enacted in July.

Postviability Abortion

KANSAS: In May, the Senate failed in its attempt to override then-Gov. Kathleen Sebelius’ (D) veto of a measure that would have revised the state’s postviability abortion law. Current law defines fetal viability as the point at which a physician determines a fetus can survive without the “application of extraordinary measures.” In an attempt to establish viability at an earlier stage in pregnancy, the bill would have changed the viability standard to the point at which a fetus can survive with or without medical intervention. The measure, which passed the legislature in April, would have also banned “partial-birth” abortion and amended the state’s requirements for abortion reporting and abortion counseling.

KANSAS: In March, the House adopted a bill that would revise the state’s postviability abortion law. Current law defines fetal viability as the point at which a physician determines a fetus can survive without the “application of extraordinary measures.” In an attempt to establish viability at an earlier stage in pregnancy, the bill would change the viability standard to the point at which a fetus can survive with or without medical intervention. The measure would also ban “partial-birth” abortion and amend the state’s requirements for abortion reporting and abortion counseling. No further action is expected on the measure since a smiliar bill was vetoed by then-Gov. Kathleen Sebelius (D).

(ENACTED) UTAH: In March, Gov. Jon Huntsman Jr. (R) signed into law a bill that amends the state’s postviability abortion law. Currently, the law prohibits an abortion of a viable fetus during the third trimester unless the woman’s physical or mental health is seriously at risk, there is a fetal abnormality or the abortion is necessary to save the woman’s life. The bill will allow abortion after viability in cases of life endangerment, “serious risk of substantial and irreversible impairment of a major bodily function,” severe fetal abnormality as certified by two physicians, or rape or incest reported to the police. Providing an abortion except in one of these circumstances will be a felony. The measure, which passed the legislature in February, goes into effect in May.

Private Insurance Coverage of Abortion

Prohibiting Forcing a Woman to Have an Abortion

Introduced in 12 states

Bill Status:

Passed at least one chamber in MO

Enacted in AZ, KS, ND and OH

ARIZONA: In September, a state court judge allowed several provisions of a new state statute to go into effect, including a counseling requirement mandating that medical providers tell women that they cannot be coerced into having an abortion. The court blocked several other sections of the statute, including provisions related to in-person abortion counseling, parental consent, physician-only requirements and refusal clauses; it permitted implementation of provisions relating to a waiting period, standards for abortion counseling, coercion and minors’ abortions. The law was enacted in July.

(ENACTED) KANSAS: In March, Gov. Kathleen Sebelius (D) signed a bill that will require abortion facilities to post a notice informing women that they cannot be coerced into having an abortion and that an abortion may only be performed if the woman has voluntarily consented to the procedure; it will also inform women that they can contact a law enforcement agency if they feel that they have been the victim of coercion. The measure, which also contains provisions regarding informed consent and ultrasound, passed the legislature in March and goes into effect July 1, 2009.

MISSOURI: In May, the Senate deleted provisions related to coerced abortion that were part of a larger abortion bill that had already passed the House in March. Although the Senate retained provisions that would have amended the state’s law on abortion counseling, ultrasound, hospital requirements and fetal pain, the bill died in a conference committee when the legislature adjourned.

(ENACTED) NORTH DAKOTA: In April, Gov. John Hoeven (R) signed into law a measure that requires abortion facilities to prominently display signs containing the following statement: “No one can force you to have an abortion. It is against the law for a spouse, a boyfriend, a parent, a friend, a medical care provider, or any other person to in any way force you to have an abortion” The signs will be posted on the Department of Health’s Web site for abortion facilities to print out and post. The measure, which passed the Senate in February and the House in March, goes into effect August 1, 2009.

(ENACTED) OHIO: In January, a law requiring facilities that perform abortions to display a sign stating that a woman cannot be coerced into having an abortion and encouraging any woman who feels that she has been coerced to discuss the issue with clinic staff was enacted without Gov. Ted Strickland’s (D) signature. The measure passed the legislature in October 2008. The law, which also increases the penalty for domestic violence if the offender knew the woman was pregnant at the time, goes into effect in April.

Protecting Access to Clinics

DELAWARE: In June, the Senate passed a measure that would prohibit a person from obstructing or hindering entry into or exit from a health care facility. The measure prohibits anyone from coming within eight feet of someone near the facility to counsel, educate or protest about abortion without that person’s consent. No further action is expected since the legislature has adjourned its regular session.

MASSACHUSETTS: In July, the U.S. Court of Appeals for the First Circuit affirmed the U.S. District Court of Massachusetts’s 2008 decision to uphold the state’s 2007 law that established a 35-foot “buffer zone” around reproductive health facilities’ entrances and surrounding walkways. The law is currently in effect.

MONTANA: In March, the Senate passed a measure that would protect clinic protesters by penalizing anyone who approached them without their consent, except when necessary to enter or exit the clinic. No further action is expected since the legislature has adjourned its regular session.

(ENACTED) NEW YORK: In October, Gov. David Paterson (D) signed into law a measure that will consider it a felony to cause physical harm to a person accessing reproductive health services. State law currently makes it a misdemeanor to injure or intimidate someone seeking services. The bill, which passed the Assembly in June and the Senate in September, goes into effect in January 2010.

Public Funding of Abortion for Low-Income Women

(ENACTED) IOWA: In May, Gov. Chet Culver (D) signed into law a measure that will continue the state’s policy of paying for abortions within the Medicaid program in cases of fetal abnormality, rape, incest and life endangerment. The law, which passed the legislature in April, goes into effect in July.

(ENACTED) MARYLAND: In May, a measure went into effect without the signature of Gov. Martin O’Malley (D) that will reenact current restrictions prohibiting public funding of abortion unless the pregnancy is the result of incest or rape, the woman’s life is at risk, the fetus is affected by a serious abnormality, or the woman’s physical and mental health is at grave risk. The law, which passed the legislature in April, goes into effect in July.

(ENACTED) MINNESOTA: In May, Gov. Tim Pawlenty signed budget legislation that continues the state's policy of funding medically necessary abortions. The budget passed the Senate in April and the House in May. It goes into effect in July.

VIRGINIA: In February, both chambers adopted the state’s budget without a provision that would have limited public funds for abortion under Medicaid to cases of life endangerment, rape and incest; it would have excluded funding in cases of fetal abnormality. The version of the bill that passed the House earlier in February included these restrictions on publicly funded abortions as well as provisions that would have prohibited Planned Parenthood from receiving state funds and would have mandated that abortion clinics meet certain requirements. It was signed by Gov. Tim Kaine (D) in April.

Reporting
Statistical Information to State Agencies

KANSAS: In May, the Senate failed in its attempt to override then-Gov. Kathleen Sebelius’ (D) veto of a measure that would have mandated that a provider include information on the specific diagnosis for a postviability abortion and a written certification by the provider and another physician that the procedure was necessary. The provider and the physician also would have been required to certify in writing that they did not have a legal or financial relationship. The measure, which passed the legislature in April, would have also amended the state’s law on postviability abortion and abortion counseling and banned “partial-birth” abortion.

KANSAS: In March, the House approved a measure that would expand the state’s current abortion reporting requirements to mandate that a provider include information on the specific diagnosis for a postviability abortion and a written certification by the provider and another physician that the procedure was necessary. The provider and the physician would also be required to certify in writing that they do not have a legal or financial relationship. The measure also contains provisions regarding postviability abortion counseling and partial birth abortion. No further action is expected since then-Gov. Kathleen Sebelius (D) vetoed a similar bill in April.

OKLAHOMA: In October, a district judge blocked a law enacted in May, that would have revised and expanded the state’s requirements for abortion reporting from going into effect pending the resolution of a court case. The requirements would have mandated that providers report cost and payment information, whether anesthesia was provided to the fetus, and whether and how abortion counseling and written materials were provided to the woman. They would have also been required to ask the woman why she obtained the abortion; one possible response would be that she “wanted a child of a different sex.” The law would also penalize providers for knowingly performing an abortion for purposes of sex selection.

Requiring
Abortion Providers to Have Hospital Privileges

INDIANA: In April, the House passed a measure that would require abortion providers to have admitting privileges at a hospital adjacent to or within the county where they provide abortions. The measure also contains a provision on fetal pain. The Senate passed the measure in February. No further action is expected since the legislature has adjourned its regular session.

MISSOURI: In May, the Senate passed a measure that would require that an abortion provider have hospital admitting privileges 30 miles from where the abortion would be performed. The bill, which also contains provisions regarding informed consent, ultrasound and fetal pain, was adopted by the House in March. The measure died in a conference committee when the legislature adjourned.

Sex Selection

Introduced in 6 states

Bill Status:

Enacted in OK

OKLAHOMA: In October, a district judge blocked a law that would have penalized providers for knowingly performing an abortion for the purpose of sex selection from going into effect pending resolution of a court case. The law would have also revised and expanded the state’s requirements for abortion reporting. It was enacted in May.

State Participation in Abortion

Targeted
Regulation of Abortion Providers

Introduced in 8 states

Bill Status:

Passed at least one chamber in VA

VIRGINIA: In February, both chambers adopted the state’s budget without a provision that would have classified facilities that provide 25 or more first-trimester abortions a year as ambulatory surgical centers, which would subject them to increased regulation by the state. The version of the bill that passed the House in February included these abortion facility requirements as well as provisions to limit public funds for abortion and to prohibit Planned Parenthood from receiving state funds. It was signed by Gov. Tim Kaine (D) in April.

Ultrasound Requirements

(ENACTED)KANSAS: In March, Gov. Kathleen Sebelius (D) signed a bill requiring that if an ultrasound is performed prior to an abortion, the provider must offer the woman an opportunity to view the image. Similarly, if heart monitoring equipment is used, the woman must be offered the opportunity to hear the fetal heartbeat. The measure, which also contains provisions regarding coercion and informed consent, passed the legislature in March and goes into effect July 1, 2009.

KENTUCKY: In March, the House and Senate approved separate but identical measures that would require an abortion provider to perform an ultrasound prior to an abortion, explain the results of the ultrasound and review the image with the woman. The woman would be entitled to “avert her eyes” from the monitor during the review, and would not be penalized for refusing to look at the image. The measures, which also contain a waiting period provision, are not expected to advance further since the legislature has adjourned its regular session.

MISSOURI: In May, the Senate amended provisions related to ultrasound that were part of a larger abortion bill that had passed the House in March. The bill would have required a provider to offer a woman seeking an abortion the option of obtaining an ultrasound before the procedure and to give her a list of organizations that perform ultrasound examinations. If the woman opted to have the ultrasound, the procedure would have had to be performed at least 24 hours prior to the abortion. The provider would also have been required to give the woman the opportunity to hear the fetal heartbeat, if audible. The bill, which also contained provisions regarding abortion counseling, hospital requirements and fetal pain, died in a conference committee when the legislature adjourned.

(ENACTED) NEBRASKA: In May, Gov. Dave Heineman (R) signed a measure that requires that when an ultrasound is performed prior to an abortion, the abortion provider must display the image so the woman can see it and answer any questions the woman has about the ultrasound. The provider will also be required to offer to the woman a list of organizations that perform ultrasound examinations as part of abortion counseling. The law goes into effect in August.

(ENACTED) NORTH DAKOTA: In April, Gov. John Hoeven (R) signed into law a measure that requires abortion clinics to offer a woman seeking an abortion an ultrasound at least 24 hours prior to the procedure. The measure also requires abortion providers to keep records of the number of women who accept the offer to have an ultrasound, the number who decline and the number in each group who go on to have an abortion. The measure, which passed the House in January and the Senate in April, goes into effect August 1, 2009.

OKLAHOMA: In August, a state district court struck down the state’s ultrasound law—one of the strictest laws of its type in the country. The law, which was never in effect, would have required that an abortion provider perform an ultrasound on each woman seeking an abortion, display the ultrasound image so she could see it and describe it in detail; the woman would have had the option to “avert” her eyes from the image. The court ruled that the law violated the state’s constitutional provision that requires laws to address only one subject. The law’s other provisions require providers to follow the U.S. Food and Drug Administration protocol for medication abortion, require mandatory signage telling women they cannot be coerced into abortions and allow health care providers to refuse to participate in abortion.

SOUTH CAROLINA: In February, the House passed a bill that would expand current state policy requiring that a woman seeking an abortion be offered an ultrasound at least 24 hours prior to the procedure. Under the bill, the provider would be required to tell the woman the probable gestational age of the fetus. The measure would also increase the waiting period for a woman seeking an abortion. No further action is expected since the legislature has adjourned its regular session.

TEXAS: In May, the Senate adopted an omnibus abortion bill containing provisions that would require a provider to offer a woman seeking an abortion the option of obtaining an ultrasound. The woman would also be given state-developed abortion counseling materials, which would be revised to include a list of organizations that perform free ultrasound examinations. The measure, which also contains provisions related to abortion counseling and medical emergency, died when the legislature adjourned its regular session.

VIRGINIA: In February, a Senate committee defeated a bill that would have required abortion providers to perform an ultrasound on every woman seeking an abortion and offer the woman the option to see the image. The bill passed the House earlier in February.

Abortion-Related Restrictions on Family Planning Funds

(ENACTED) COLORADO: In March, Gov. Bill Ritter (D) signed into law a measure that reenacts a longstanding prohibition of giving state family planning funds to organizations that provide abortion services with their own funds. The measure, which passed the legislature in February, is in effect.

KANSAS: In May, Gov. Mark Parkinson (D) vetoed language in the budget bill that would have required family planning funds dispensed by a state agency to be dispersed on a priority-based system. Facilities run by health agencies would have had the highest priority, followed by private hospitals and federally qualified health centers. The language was amended into the bill by a conference committee.

KANSAS: In March, a conference committee deleted a provision that would have required family planning funds dispensed by a state agency to be dispersed on a priority-based system. Facilities run by health agencies would have had the highest priority, followed by private hospitals and federally qualified health centers. The bill passed the Senate with this provision in March.

(ENACTED) MICHIGAN: In October, Gov. Jennifer Granholm (D) signed into law the final version of a budget that would prohibit the use of state family planning funds for abortion services, including counseling and referral. The measure, which passed the House in April and the Senate in June, is in effect.

(ENACTED) TENNESSEE: In July, Gov. Phil Bredesen (D) signed into law a measure that institutes a pilot program for distributing state family planning funds in counties whose population exceeds 500,000. The program requires family planning funds to be dispensed by the health care commissioner on a priority-based system giving county health departments highest priority. The law, which passed the legislature in June, goes into effect in January.

(ENACTED) TEXAS: In June, Gov. Rick Perry (R) signed into law the state’s budget bill that includes provisions meant to increase restrictions on organizations’ eligibility for state family planning funds. Under the measure, organizations must maintain incorporation, governing structure and bookkeeping that are separate from abortion providers. The bill also continues the requirement that agencies receiving state funding must obtain parental consent before providing minors with prescription contraceptives. It will also include funding for alternatives-to-abortion services. The measure, which passed the legislature in April, goes into effect in September.

VIRGINIA: In February, both chambers adopted the state’s budget without a provision that would have prohibited any funds going through the state treasury from being allocated to Planned Parenthood affiliates. The version of the bill that passed the House earlier in February included this prohibition as well as provisions that would have limited the circumstances under which public funds may be used for abortion and would have mandated that abortion clinics meet certain requirements. It was signed by Gov. Tim Kaine (D) in April.

Contraceptive Coverage Mandates

(ENACTED) WISCONSIN: In June, Gov. Jim Doyle (D) signed the state’s budget that requires all health plans to cover contraceptive drugs and services if the plan covers outpatient services, preventive care or prescription drugs. The budget, which also includes a provision altering the state’s Medicaid family planning expansion to include men, includes alternatives-to-abortion funding and requires pharmacies to fill valid contraceptive prescriptions and dispense Plan B, was adopted by the legislature in June, and goes into effect in January 2010.

Defining Contraception

Introduced in 3 states

Bill Status:

Enacted in CO

(ENACTED) COLORADO: In April, Gov. Bill Ritter (D) signed into law a measure that defines contraception as “a medically acceptable drug, device or procedure used to prevent pregnancy” in order to ensure that state restrictions on abortion do not apply to contraception. The measure, which passed the legislature in March, is in effect.

HAWAII: In March, the Senate adopted a measure that would require hospitals to provide medically accurate information on emergency contraception to a woman who has been sexually assaulted. The measure would also require hospitals to provide the medication when requested by the woman. No further action is expected since the legislature has adjourned its regular session.

(ENACTED) UTAH: In March, Gov. Jon Huntsman Jr. (R) signed into law a measure that requires hospitals to provide medically accurate information on emergency contraception to a woman who has been sexually assaulted. A practitioner is required to dispense emergency contraception or to provide information on the medication and the medication upon request. The law goes into effect in June.

Allowing
Pharmacists to Provide Emergency Contraception without a Prescription

Introduced in 1 state

Expanding
Access to Emergency Contraception

Introduced in 4 states

Bill Status:

Enacted in VA

(ENACTED) VIRGINIA: In March, Gov. Tim Kaine (D) signed into law a measure that would allow a “prescriber” to authorize a certified sexual assault nurse examiner to provide CDC-recommended preventative medicines, such as emergency contraception, to women who have been sexually assaulted. The bill, which passed the legislature in February, goes into effect in July.

Requiring
Pharmacists or Pharmacies to Dispense Contraception

Introduced in 13 states

Bill Status:

Enacted in WI

(ENACTED) WISCONSIN: In June, Gov. Jim Doyle (D) signed the state’s budget that requires a pharmacy to fill a contraceptive prescription and dispense Plan B without delay and within the same time frame that valid non-contraceptive prescriptions are filled. The budget, which was adopted by the legislature in June, goes into effect in July.

HPV: Insurance Coverage

Introduced in 8 states

Bill Status:

Enacted in OR

Vetoed in CA

CALIFORNIA: In October, Gov. Arnold Schwarzenegger (R) vetoed a bill that would have required group health insurance plans that cover cervical cancer treatment and surgery to also cover HPV vaccines. The bill passed the Senate in May and the Assembly in September.

(ENACTED) OREGON: In June, Gov. Ted Kulongoski (D) signed into law a measure that requires health care plans to cover the HPV vaccine for girls and women aged 11 to 26. The bill, which passed the House in April without an upper age limit, goes into effect in January 2010.

HPV Vaccine: Required for School Entry

Partner Treatment for Sexually Transmitted Infections

Introduced in 8 states

Bill Status:

Passed at least one chamber in NV

Enacted in IL, ND, OR, UT and VT

(ENACTED) ILLINOIS: In August, Gov. Pat Quinn (D) signed into law a measure that will allow a medical provider to prescribe or dispense a drug for treatment of chlamydia or gonorrhea for a partner of one of their patients without first seeing the partner. The provider will also be able to provide counseling and information for the patient to give to the partner. The law, which passed the Senate in April and the House in May, goes into effect in January 2010.

NEVADA: In May, the House passed a measure that would allow a medical provider associated with a state-funded health care facility to prescribe or dispense a drug for treatment of STIs for a patient’s partner without first seeing the partner. Other medical providers would be allowed to provide patients with a written STI diagnosis, which a patient’s partner would be permitted to present to a state-funded health care facility for treatment without examination. In April, the House adopted a broader version of the measure, which would allow all providers to treat patients’ partners for an STI; as a result. No further action is expected as the legislature adjourned its regular session before the conference committee could come to an agreement on the measure.

(ENACTED) NORTH DAKOTA: In April, Gov. John Hoeven (R) signed into law a measure that will allow a medical practitioner to treat a patient’s partner for STIs. The bill, which passed the legislature in March, goes into effect in August.

(ENACTED) OREGON: In June, Gov. Ted Kulongoski (D) signed into law a measure that permits health care professional boards to adopt regulations allowing providers to prescribe or dispense a drug for the treatment of an STI for a partner of one of their patients without first seeing the partner. The boards must consult with the Department of Health to decide what STIs would be appropriate to treat using this method. The bill, which passed the House in April and the Senate in May, goes into effect in January 2010.

(ENACTED) UTAH: In March, Gov. Jon Huntsman Jr. (R) signed into law a measure that allows a medical provider to prescribe or dispense a drug for treatment of chlamydia or gonorrhea for a partner of one of their patients without first seeing the partner. The bill, which passed the House in February and the Senate in March, goes into effect in May.

(ENACTED) VERMONT: In June, Gov. Jim Douglas (R) signed into law a measure that allows a health care provider to prescribe or dispense a drug for the treatment of chlamydia for a partner of one of their patients without first seeing the partner. It will also require the provider to give a patient written materials for the partner that recommend seeing a medical provider in person and being cautious of medication allergies. The bill, which passed the House in April and the Senate in May, goes into effect in July.

State
Medicaid Family Planning Eligibility Expansions

(ENACTED) GEORGIA: In March, Gov. Sonny Perdue (R) signed into law a measure that allocates $50,000 for a federal waiver to provide family planning services to women with an income up to 200% of the federal poverty line. The law is in effect.

NORTH DAKOTA: In February, the Senate defeated a bill that would have required the health department to apply for a state Medicaid family planning expansion waiver.

(ENACTED) WISCONSIN: In June, Gov. Jim Doyle (D) signed the state’s budget that expands the state’s Medicaid family planning expansion to include men. Currently, the program covers women aged 15–44 who have an income of up to 200% of the federal poverty level. The budget, which also includes alternatives-to-abortion funding, mandates contraceptive coverage for health insurance policies and requires pharmacies to fill valid contraceptive prescriptions and dispense Plan B, was adopted by the legislature in June, and goes into effect in July.

PREGNANCY & BIRTH

Fetal and Pregnant Woman Assault

Introduced in 15 states

Bill Status:

Passed at least one chamber in MT and WY

Enacted in IN and OR

(ENACTED) INDIANA: In April, Gov. Mitch Daniels signed a measure that allows for a separate murder charge to be filed if a fetus of any gestation dies because the pregnant woman was murdered or if an attempt was made on her life. Under current law, a separate murder charge can be filed only when the fetus was viable. The bill also increases the penalties for providing an illegal abortion. The measure, which passed the Senate in February and the House in April, goes into effect in July.

MONTANA: In March, a House committee defeated a measure that would have made it possible to consider a fetus a victim under the state’s assault and murder statutes. The bill passed the Senate in March.

(ENACTED) OREGON: In July, Gov. Ted Kulongski (D) signed a measure that amends the state’s criminal statutes to include the crime of murdering or assaulting a pregnant woman when the perpetrator is aware the woman is pregnant. The bill passed the legislature in June and goes into effect in January.

WYOMING: In February, the Senate adopted a measure that would permit the imposition of the death penalty in a case involving the murder of a woman known by perpetrator to be pregnant. No further action is expected since the legislature has adjourned its regular session.

HIV
Testing of Infants and Pregnant Women

Introduced in 13 states

Bill Status:

Passed at least one chamber in KS, RI and TX

Enacted in CO, CT, DE, HI, MT and TX

(ENACTED) COLORADO: In April, Gov. Bill Ritter (D) signed into law a measure that requires a physician to test a pregnant woman for HIV either during prenatal care or at delivery, unless she refuses. The bill, which passed the Senate in February, and the House in March, is in effect.

(ENACTED) CONNECTICUT: In June, Gov. Jodi Rell (R) signed into law a measure that allows a health care provider to test a pregnant woman for HIV without obtaining her consent as long as she has been told, as part of the general informed consent process, that an HIV test may be performed and that she has the right to decline the test. The law, which passed the legislature in May, goes into effect in July.

(ENACTED) DELAWARE: In July, Gov. Jack Markell (D) signed into law a measure that includes HIV screening of pregnant women in the routine panel of prenatal tests, unless the woman declines. Previously, state policy required a health care provider to get consent before testing a pregnant woman for HIV. The law, which passed the legislature in June, is in effect.

(ENACTED) HAWAII: In June, Gov. Linda Lingle (D) signed into law a measure that allows health care providers to test patients for HIV with their consent only if patients have been counseled about the test and their right to refuse in advance. The law, which passed the House in April and the Senate in March, is in effect.

KANSAS: In March, the Senate passed a measure that would require a physician or other health care professional to offer a pregnant woman an HIV test either during prenatal care or at delivery. The woman would be informed in writing of the HIV screening and would sign a form consenting to or opting out of the test. The bill would also mandate that a provider perform an HIV test on an infant born to a mother who has not been tested for HIV, unless a parent refuses the test on the basis of religious beliefs. The mother would sign a form verifying that informed in writing of the newborn screening procedure. No further action is expected since the legislature has adjourned its regular session.

(ENACTED) MONTANA: In April, Gov. Brian Schweitzer (D) signed into law a measure that will require a prenatal care provider to inform a woman that an HIV test will be performed unless she refuses. The measure will also stipulate that a provider can offer HIV testing during the third trimester or when a patient presents for labor and delivery with unknown HIV status. The bill, which passed the Senate in March and the House in April, goes into effect in October.

RHODE ISLAND: In June, the House and Senate approved separate but identical measures that would require a woman in labor whose HIV status is unknown to be tested unless she declines. The bills would also mandate that a provider perform an HIV test on an infant born to a mother who had not been tested; the test could occur without the mother’s consent if reasonable steps had been taken to obtain her consent. The bills, which were adopted by their chamber of origin in May, are awaiting final action by the legislature.

(ENACTED) TEXAS: In June, Gov. Rick Perry (R) signed into law a measure that requires a health care provider to test a pregnant woman for HIV in her third trimester. The bill will also mandate that a provider perform an HIV test on an infant born to a mother who had not been tested unless a parent or guardian objects. Current policy only requires testing a pregnant woman at her first examination. The bill, which passed the legislature in May, goes into effect in September.

TEXAS: In May, the Senate passed a measure that would mandate that a pregnant woman be tested for HIV in her third trimester unless she declines the test. The bill would also require that a provider perform an HIV test on an infant born to a mother whose HIV status is unknown unless she declines. No further action is expected since the legislature has adjourned its regular session and a similar bill was enacted.

Infant Abandonment

(ENACTED) ARIZONA: In July, Gov. Jan Brewer (R) signed into law a measure that adds “rural general hospitals” to the list of approved places at which one can relinquish an infant. The bill also mandates that a person surrendering an infant at a health care facility give the infant to a member of the medical staff. The law, which passed the Senate in June and the House in July, goes into effect in October.

CALIFORNIA: In June, the Assembly passed a measure that would expand the age that an infant can be legally relinquished from 72 hours to 30 days. No further action is expected, since the legislature has adjourned its regular session.

(ENACTED) ILLINOIS: In August, Gov. Pat Quinn (D) signed into law a measure that will extend the age limit at which an infant can be legally relinquished from seven to 30 days. The bill, which passed the House in March and the Senate in May, goes into effect in June 2010.

NORTH DAKOTA: In April, the Senate failed to pass a conference committee report that would have amended the state’s current infant abandonment policy to include fire stations as an acceptable location to legally relinquish an infant. The bill, which passed the legislature in April and had been reported from a conference committee, is now dead.

NORTH DAKOTA: In February, a Senate committee defeated a bill that would have included fire stations as a permissible location to legally relinquish an infant.

(ENACTED) TENNESSEE: In May, Gov. Phil Bresden (D) signed into law a measure that will amend the state’s current infant abandonment policy to include police and fire stations as well as “emergency medical services facilities” as acceptable locations to legally relinquish an infant. The law, which passed the Senate in April and the House in May, is in effect.

(ENACTED) WASHINGTON: In May, Gov. Christine Gregorie (D) signed into law a measure that will include medical clinics during their hours of operation as an acceptable location to legally relinquish an infant. The bill would also mandate that a sign be displayed at locations where it is legal to surrender infants. The measure, which passed the Senate in March and the House in April, goes into effect in July.

(ENACTED) WASHINGTON, DC: In April, a new District of Columbia law went into effect that would allow a parent to legally relinquish an unharmed infant up to seven days old at a hospital. The law is in effect but will expire in February of 2010.

Infertility
Coverage

Non-Medical Use of Ultrasound

Introduced in 3 states

Bill Status:

Passed at least one chamber in NJ

Enacted in CT

(ENACTED) CONNECTICUT: In June, Gov. Jodi Rell (R) signed into law a measure designed to halt nonmedical use of ultrasound. The new law limits ultrasound examinations to those that have been ordered by a medical provider and conducted for a medical purpose. The law, which passed the House in April and the Senate in May, goes into effect in July.

NEW JERSEY: In May, the Assembly passed a measure that would limit the sale of ultrasound technology to health care providers, licensed medical facilities and medical schools. The measure is awaiting action in the Senate.

Stillborn Certificates

Introduced in 9 states

Bill Status:

Passed at least one chamber in NM

Enacted in AK and ME

(ENACTED) ALASKA: In May, Gov. Sarah Palin (R) signed a measure that allows the state to issue a certificate of stillbirth when requested by a parent. The medical provider is required to inform the parent about the option to obtain the certificate. The measure, which passed the House in March and the Senate in April, goes into effect in July.

(ENACTED) MAINE: In June, Gov. John Baldacci (D) signed into law a measure that allows a parent to request a certificate for a stillbirth. The measure, which passed the Senate and the House in June, went into effect in June.

NEW MEXICO: In February, the House adopted a measure that would allow for a certificate of birth resulting in a stillbirth to be issued for a fetal death. No further action is expected since the legislature had adjourned its regular session.

Substance Abuse During Pregnancy

(ENACTED) ARKANSAS: In April, Gov. Mike Beebe (D) signed into law a measure that will include the presence of illegal substances in a newborn's system in the state's definition of "child neglect." The bill will also allow for test results of the infant and mother to be used as evidence of neglect. The measure, which passed the legislature in March, goes into effect in July.

CALIFORNIA: In October, Gov. Arnold Schwarzenegger (R) vetoed a measure that would have required the Department of Health to institute a program to provide alcohol and drug screening and treatment to women eligible for Medicaid who are pregnant or of childbearing age. The bill passed the Assembly in June and the Senate in September.

TENNSESSEE: In May, the House passed a measure that would permit a physician to perform a drug test on a newborn if he or she suspects that the newborn was exposed to controlled substances prenatally. If the newborn’s test comes back positive, the physician would be required to make a report to child services. Also, the bill would require the state to assist pregnant women and new mothers in obtaining treatment for their addictions. No futher action is expected since the legislature has adjourned its regular session.

ARIZONA: In September, a state court judge blocked enforcement of a provision of a new state statute that would have allowed a hospital, medical provider or its employees to refuse to participate in an abortion. The measure would have also expanded the law by allowing these entities to also refuse to facilitate an abortion. The court blocked several other sections of the statute, including provisions related to in-person abortion counseling, parental consent and physician-only requirements; it permitted implementation of provisions relating to a waiting period, standards for abortion counseling, coercion, medical emergency and minors’ abortions. The law was enacted in July.

(ENACTED) LOUISIANA: In July, Gov. Bobby Jindal (R) signed a measure that allows anyone, including medical providers and pharmacists, to refuse to provide specific services, such as abortion and dispensing drugs for medication abortion. Health care facilities must ensure that patients can access services in a timely manner, even if a provider refuses to perform the service. The measure would also require refusing providers to notify their employer or prospective employer of the refusal and to inform patients of their refusal when a patient requests the service. The law, which passed the legisalture in June, goes into effect in August.

LOUISIANA: In June, the Senate adopted an amendment that would allow any person to refuse to engage in any activity based on religious belief. The amendment passed the House in May. A conference committee was not able to agree on a final version of the amendment when the legislature adjourned in June.

Allowing
Insurers to Refuse

Introduced in 5 states

Allowing
Pharmacists or Pharmacies to Refuse

Introduced in 12 states

Bill Status:

Passed at least one chamber of the leigslature in ID, LA and MO

Enacted in AZ and LA

ARIZONA: In September, a state court judge blocked enforcement of a provision of a new state statute that would have allowed a hospital, medical provider or its employees to refuse to participate in an abortion. The measure would have also expanded the law by allowing these entities to also refuse to facilitate an abortion. The court blocked several other sections of the statute, including provisions related to in-person abortion counseling, parental consent and physician-only requirements; it permitted implementation of provisions relating to a waiting period, standards for abortion counseling, coercion, medical emergency and minors’ abortions. The law was enacted in July.

IDAHO: In March, the House adopted a measure that would allow a pharmacist to refuse to provide services because of a religious, moral or ethical objection. The measure would protect the pharmacist or the pharmacist’s employer from liability. However, a refusal cannot be based on the patient’s race, color, religion, sex or national origin. No further action is expected since the legislature has adjourned its regular session.

(ENACTED) LOUISIANA: In July, Gov. Bobby Jindal (R) signed a measure that allows anyone, including medical providers and pharmacists, to refuse to provide specific services, such as abortion and dispensing drugs for medication abortion. Health care facilities must ensure that patients can access services in a timely manner, even if a provider refuses to perform the service. The measure would also require refusing providers to notify their employer or prospective employer of the refusal and to inform patients of their refusal when a patient requests the service. The law, which passed the legisalture in June, goes into effect in August.

LOUISIANA: In June, the Senate adopted an amendment that would allow any person to refuse to engage in any activity based on religious belief. The amendment passed the House in May. A conference committee was not able to agree on a final version of the amendment when the legislature adjourned in June.

MISSOURI: In May, a conference committee deleted provisions in a measure that would have allowed pharmacies to refuse to dispense drugs or participate in services, such as referral, related to abortifacients. Because the legislation would have defined emergency contraception as an abortifacient, it would have also permitted pharmacies to refuse to provide emergency contraception services, including dispensing and referral. The measure, with these provisions, passed the House in April.

Allowing Facilities to Refuse

Introduced in 8 states

Bill Status:

Enacted in AZ

ARIZONA: In September, a state court judge blocked enforcement of a provision of a new state statute that would have allowed a hospital, medical provider or its employees to refuse to participate in an abortion. The measure would have also expanded the law by allowing these entities to also refuse to facilitate an abortion. The court blocked several other sections of the statute, including provisions related to in-person abortion counseling, parental consent and physician-only requirements; it permitted implementation of provisions relating to a waiting period, standards for abortion counseling, coercion, medical emergency and minors’ abortions. The law was enacted in July.

ARIZONA: In September, a state court judge blocked enforcement of a provision that would have allowed a pharmacy, hospital, medical provider or its employees to refuse to participate in or facilitate access to emergency contraception or contraceptive methods that prevent implantation of a fertilized egg. The court blocked several other sections of the statute, including provisions related to in-person abortion counseling, parental consent and physician-only requirements; it permitted implementation of provisions relating to a waiting period, standards for abortion counseling, coercion, medical emergency and minors’ abortions. The law was enacted in July.

LOUISIANA: In June, the Senate adopted an amendment that would allow any person to refuse to engage in any activity based on religious belief. The amendment passed the House in May. A conference committee was not able to agree on a final version of the amendment when the legislature adjourned in June.

Allowing Insurers to Refuse

Introduced in 5 states

Allowing Pharmacies to Refuse

Introduced in 8 states

Bill Status:

Passed at least one chamber in MO

Enacted in AZ

ARIZONA: In September, a state court judge blocked enforcement of a provision that would have allowed a pharmacy, hospital, medical provider or its employees to refuse to participate in or facilitate access to emergency contraception or contraceptive methods that prevent implantation of a fertilized egg. The court blocked several other sections of the statute, including provisions related to in-person abortion counseling, parental consent and physician-only requirements; it permitted implementation of provisions relating to a waiting period, standards for abortion counseling, coercion, medical emergency and minors’ abortions. The law was enacted in July.

MISSOURI: In May, a conference committee deleted provisions in a measure that would have allowed pharmacies to refuse to provide services related to emergency contraception, including dispensing the drug or providing referrals. The measure would have also permitted pharmacies to refuse to provide services related to abortifacients, which, under the bill, would include emergency contraception. The measure, with these provisions, passed the House in April.

Allowing Pharmacists to Refuse

Introduced in 12 states

Bill Status:

Passed at least one chamber in ID and LA

Enacted in AZ

ARIZONA: In September, a state court judge blocked enforcement of a provision that would have allowed a pharmacy, hospital, medical provider or its employees to refuse to participate in or facilitate access to emergency contraception or contraceptive methods that prevent implantation of a fertilized egg. The court blocked several other sections of the statute, including provisions related to in-person abortion counseling, parental consent and physician-only requirements; it permitted implementation of provisions relating to a waiting period, standards for abortion counseling, coercion, medical emergency and minors’ abortions. The law was enacted in July.

IDAHO: In March, the House adopted a measure that would allow a pharmacist to refuse to provide services because of a religious, moral or ethical objection. The measure would protect the pharmacist or the pharmacist’s employer from liability. However, a refusal cannot be based on the patient’s race, color, religion, sex or national origin. No further action is expected since the legislature has adjourned its regular session.

LOUISIANA: In June, the Senate adopted an amendment that would allow any person to refuse to engage in any activity based on religious belief. The amendment passed the House in May. A conference committee was not able to agree on a final version of the amendment when the legislature adjourned in June.

LOUISIANA: In June, the Senate adopted an amendment that would allow any person to refuse to engage in any activity based on religious belief. The amendment passed the House in May. A conference committee was not able to agree on a final version of the amendment when the legislature adjourned in June.

Allowing Insurers to
Refuse

Introduced in 5 states

Allowing Pharmacists
or Pharmacies to Refuse

Introduced in 8 states

Bill Status:

Passed at least one chamber in ID and LA

IDAHO: In March, the House adopted a measure that would allow a pharmacist to refuse to provide services because of a religious, moral or ethical objection. The measure would protect the pharmacist or the pharmacist’s employer from liability. However, a refusal cannot be based on the patient’s race, color, religion, sex or national origin. No further action is expected since the legislature has adjourned its regular session.

LOUISIANA: In June, the Senate adopted an amendment that would allow any person to refuse to engage in any activity based on religious belief. The amendment passed the House in May. A conference committee was not able to agree on a final version of the amendment when the legislature adjourned in June.

YOUTH

Child Abuse Reporting

Introduced in 5 states

Bill Status:

Passed at least one chamber in MS

MISSISSIPPI: In March, a House committee defeated a measure that would have required Vital Records and Board of Health employees, along with teachers and principals, to report to the authorities certain instances where a minor younger than 14 became pregnant, gave birth or had sex. The bill passed the Senate in January.

MISSISSIPPI: In March, a House committee defeated a measure that would have required individuals—including physicians and teachers—who are charged with reporting suspected cases of child abuse to report all instances of alleged or suspected sexual abuse. It would have also prohibited these individuals from using their professional discretion to determine which situations to report. In addition, the measure would have required a physician performing an abortion on a minor younger than 14 to provide a fetal tissue sample to the state bureau of investigation and crime laboratory. The bill, which would have also criminalized assisting a minor seeking an abortion without parental consent, passed the Senate in January.

Minors
Access to Reproductive Healthcare

(ENACTED) ARKANSAS: In April, Gov. Mike Beebe (D) signed into law a measure that will clarify existing law allowing minors to consent to medical or surgical care if they believe they are infected with an STI. The bill, which passed the legislature in March, goes into effect in July.

(ENACTED) NORTH DAKOTA: In April, Gov. John Hoeven (R) signed into law a measure that will require parental consent for most prenatal care received by a minor after the first trimester of pregnancy. Parental consent will not be required for care during the first trimester or for the first medical visit after the first trimester. The measure, which passed the Senate in February and the House in April, goes into effect in August.

Sex Education

(ENACTED) HAWAII: In July, the legislature overrode Gov. Linda Lingle’s (R) veto of a bill that requires all state-funded sex education programs to be medically accurate and include information on both abstinence and contraception. The measure, which passed the Senate in February and the House in April, goes into effect in July.

NEW YORK: In June, the Assembly adopted a measure that would establish a grant program for comprehensive sex education that would fund agencies such as public schools and community-based organizations. Funded programs would have to be age- appropriate and medically accurate, provide information on contraceptives, educate students about HPV, encourage family communication, provide instruction on physical changes in adolescence, and seek to develop interpersonal, decision-making and communication skills. Programs could not promote religion and must teach that abstinence is the “only sure way” to avoid pregnancy or STIs. The measure is awaiting action in the Senate.

(ENACTED) NORTH CAROLINA: In June, Gov. Beverly Perdue (D) signed a measure that substantially revises the state’s sex education statute. The state had mandated that students receive sex education that adheres to the restrictive federal definition of abstinence-only education, which, among other things, requires that programs exclusively teach the benefits of abstinence. The new law requires that sex education also include information on contraception and STIs, as well as information on sexual assault and healthy relationships. All of the instruction must be medically accurate and age-appropriate. The measure, which passed the House in April and the Senate in June, will apply to sex education classes starting in the fall of 2010.

(ENACTED) OREGON: In June, Gov. Ted Kulongoski (D) signed a bill that amends the state’s law on sex education. The bill would require that abstinence be taught as the most effective method for pregnancy and STI prevention; current law requires abstinence to be taught as the “safest and most responsible sexual behavior.” The bill would also codify an existing state regulation that requires sex education to be medically accurate. The measure, which passed the House in March and the Senate in May, goes into effect in July.

TEXAS: In May, the conference committee report for the budget, which was adopted by the legislature, continued funding for abstinence-only education programs, but did not include a provision that would have required these programs to be medically accurate. The bill had passed the Senate with the medically accurate requirement in April. The measure, which also includes longstanding restrictions on state family planning funds and funding for alternatives-to-abortion services, was signed by Gov. Rick Perry (R) in June.

(ENACTED) WASHINGTON: In April, Gov. Christine Gregoire (D) signed legislation that prohibits the state from seeking federal abstinence-only education program funds. The bill, which passed the Senate in February and the House in April, goes into effect in July.